Background/Aims: We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease- modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs. Methods: A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naïve to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)–28– erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs). Results: Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups. Conclusions Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.

PURPOSE: . This study aims to clinically compare the fitness and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems. MATERIALS AND METHODS: . Total of 40 patients were enrolled in this study, and 9 different zirconia crowns were prepared per patient. Each crown was made through the cross-application of 3 different design software (EZIS VR, 3Shape Dental System, Exocad) with 3 different processing devices (Aegis HM, Trione Z, Motion 2). The marginal gap, absolute marginal discrepancy, internal gap(axial, line angle, occlusal) by a silicone replica technique were measured to compare the fit of the crown. The scanned inner and outer surfaces of the crowns were compared to CAD data using 3D metrology software to evaluate trueness. RESULTS: . There were significant differences in the marginal gap, absolute marginal discrepancy, axial and line angle internal gap among the groups (P < .05) in the comparison of fit. There was no statistically significant difference among the groups in terms of occlusal internal gap. The trueness ranged from 36.19 to 43.78 μm but there was no statistically significant difference within the groups (P > .05). CONCLUSION . All 9 groups showed clinically acceptable level of marginal gaps ranging from 74.26 to 112.20 μm in terms of fit comparison. In the comparison of trueness, no significant difference within each group was spotted. Within the limitation of this study, open CAD-CAM systems used in this study can be assembled properly to fabricate zirconia crown. [J Adv Prosthodont 2023;15:155-70]

In acute pulmonary embolism (PE), circulatory failure and systemic hypotension are important clinically for predicting poor prognosis. While pulmonary artery (PA) clot loads can be an indicator of the severity of current episode of PE or treatment effectiveness, they may not be used directly as an indicator of right ventricular (RV) failure or patient death. In other words, pulmonary vascular resistance or patient prognosis may not be determined only with mechanical obstruction of PAs and their branches by intravascular clot loads on computed tomography pulmonary angiography (CTPA), but determined also with vasoactive amines, reflex PA vasoconstriction, and systemic arterial hypoxemia occurring during acute PE. Large RV diameter with RV/left ventricle (LV) ratio > 1.0 and/or the presence of occlusive clot and pulmonary infarction on initial CTPA, and clinically determined high baseline PA pressure and RV dysfunction are independent predictors of oncoming chronic thromboembolic pulmonary hypertension (CTEPH). In this pictorial review, authors aimed to demonstrate clinical and serial CTPA features in patients with acute massive and submassive PE and to disclose acute CTPA and clinical features that are related to the prediction of oncoming CTEPH.

BACKGROUND/AIMS: ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) has been suggested as a reliable imaging technique for monitoring of disease activity in patients with adult-onset Still’s disease (AOSD). Therefore, we investigated the clinical significance of ¹⁸F-FDG PET/CT in Korean AOSD patients. METHODS: Thirteen AOSD patients were included in the study. The PET/CT images were evaluated with visual and semiquantitative method using standardized uptake values (SUVs). RESULTS: The presence of increased ¹⁸F-FDG uptake was noted in 90% of clinically active AOSD patients. ¹⁸F-FDG uptake was located in the lymph node, spleen, and bone marrow. Visual grade and SUV intensity of lymph node was significantly correlated with the systemic score of AOSD. Visual grade of spleen was significantly correlated with the systemic score, erythrocyte sedimentation rate (ESR), and ferritin. Additionally, visual grade and SUV intensity of bone marrow was significantly correlated with the systemic score, ESR, leukocyte, and neutrophil. CONCLUSIONS: Visual grade and SUV intensity of lymph node, spleen, and bone marrow on ¹⁸F-FDG PET/CT scan showed significant correlations with known disease activity markers. The data suggest that ¹⁸F-FDG PET/CT scan may be a useful imaging technique for evaluation of disease activity in AOSD patients.
Blood Sedimentation ; Bone Marrow ; Electrons* ; Ferritins ; Humans ; Leukocytes ; Lymph Nodes ; Methods ; Neutrophils ; Positron-Emission Tomography and Computed Tomography ; Positron-Emission Tomography* ; Spleen

OBJECTIVE: The purpose of this study is to examine the difference between the numbers of patients in rheumatoid arthritis (RA) who are eligible to TNF inhibitors by the past Korean National Health Insurance reimbursement guideline and by the disease activity score with 28-joint assessment (DAS28) based criteria. METHODS: Data were obtained from a multi-center registry for biologics users in Korean RA patients, BIOlogics Pharmacoepidemiologic StudY (BIOPSY). DAS28 was calculated based on either ESR or CRP, and DAS28 of more than 5.1 or between 3.2 and 5.1 with radiographic changes was defined as a cut-off point for the initiation of TNF inhibitors. For the maintenance criteria, we used both of improving in DAS28 score (>1.2) and low disease activity (DAS 28<3.2). Differences between the numbers in each step by two criteria were described with Chi-square test and Kappa agreement. RESULTS: Of the 489 patients in BIOPSY, 299 were included in this study. Among them, 278 patients (93.0%) were eligible of TNF inhibitors when we applied the new initiation criteria with DAS28-ESR, and 244 patients (81.6%) were indicated for TNF inhibitors with DAS28-CRP. For the maintenance criteria, a low disease activity (DAS28<3.2) in 3 months after starting TNF inhibitors is too strict for achieving (33.6% with DAS28-ESR and 50.0% with DAS28-CRP). Instead, decreasing DAS28 by more than 1.2 is more reasonable as a tool for deciding early responsiveness of TNF inhibitors in RA patients (81.2% both with DAS28-ESR and DAS28-CRP). CONCLUSION: Our results show that the candidates for TNF inhibitors will be enormously changed according to a change in the reimbursement criteria. To define appropriate patients to receive TNF inhibitors, a further study with regard to the impact of changes in the reimbursement criteria on the outcomes of RA patients will be required.
Arthritis, Rheumatoid ; Biological Products ; Biopsy ; Humans ; National Health Programs

PURPOSE: The accuracy of a gypsum model (GM), which was taken using a conventional silicone impression technique, was compared with that of a polyurethane model (PM), which was taken using an iTero(TM) digital impression system. MATERIALS AND METHODS: The maxillary first molar artificial tooth was selected as the reference tooth. The GMs were fabricated through a silicone impression of a reference tooth, and PMs were fabricated by a digital impression (n=9, in each group). The reference tooth and experimental models were scanned using a 3 shape convince(TM) scan system. Each GM and PM image was superimposed on the registered reference model (RM) and 2D images were obtained. The discrepancies of the points registered on the superimposed images were measured and defined as GM-RM group and PM-RM group. Statistical analysis was performed using a Student's T-test (alpha=0.05). RESULTS: A comparison of the absolute value of the discrepancy revealed a significant difference between the two groups only at the occlusal surface. The GM group showed a smaller mean discrepancy than the PM group. Significant differences in the GM-RM group and PM-RM group were observed in the margins (point a and f), mesial mid-axial wall (point b) and occlusal surfaces (point c and d). CONCLUSION: Under the conditions examined, the digitally fabricated polyurethane model showed a tendency for a reduced size in the margin than the reference tooth. The conventional gypsum model showed a smaller discrepancy on the occlusal surface than the polyurethane model.
Calcium Sulfate* ; Models, Theoretical ; Molar ; Polyurethanes* ; Silicones ; Tooth ; Tooth, Artificial

BACKGROUND: The heme oxygenase-1 gene (HMOX1) promoter polymorphisms modulate its transcription in response to oxidative stress. This study screened for HMOX1 polymorphisms and investigated the association between HMOX1 polymorphisms and coronary artery disease (CAD) in the Korean population. METHODS: The study population consisted of patients with CAD with obstructive lesions (n=110), CAD with minimal or no lesions (n=40), and controls (n=107). Thirty-nine patients with CAD with obstructive lesions underwent follow-up coronary angiography after six months for the presence of restenosis. The 5'-flanking region containing (GT)n repeats of the HMOX1 gene was analyzed by PCR. RESULTS: The numbers of (GT)n repeats in the HMOX1 promoter showed a bimodal distribution. The alleles were divided into two subclasses, S25 and L25, depending on whether there were less than or equal to and more than 25 (GT)n repeats, respectively. The allele and genotype frequencies among groups were statistically not different. More subjects in the S25-carrier group had the low risk levels of high sensitivity C-reactive protein (hsCRP) for the CAD than those in the non-S25 carrier group (P=0.034). Multivariate logistic regression analysis revealed that the genotypes of (GT)n repeats were not related to CAD status. The restenosis group in the coronary angiography follow-up did not show any significant difference in HMOX1 genotype frequency. CONCLUSIONS: The HMOX1 genotypes were not found to be associated with CAD, but the short allele carrier group contained more individuals with hsCRP values reflecting low risk of cardiovascular disease in the Korean population.
5' Untranslated Regions ; Adult ; Alleles ; Asian Continental Ancestry Group/*genetics ; C-Reactive Protein/analysis ; Coronary Angiography ; Coronary Artery Disease/*genetics/pathology ; Coronary Restenosis/complications/therapy ; Dinucleotide Repeats/genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Heme Oxygenase-1/*genetics ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Republic of Korea ; Risk Factors

Little is known about hair mineral status in fibromyalgia patients. This study evaluated the characteristics of hair minerals in female patients with fibromyalgia compared with a healthy reference group. Forty-four female patients diagnosed with fibromyalgia according to the American College of Rheumatology criteria were enrolled as the case group. Age- and body mass index-matched data were obtained from 122 control subjects enrolled during visit for a regular health check-up. Hair minerals were analyzed and compared between the two groups. The mean age was 43.7 yr. General characteristics were not different between the two groups. Fibromyalgia patients showed a significantly lower level of calcium (775 microg/g vs 1,093 microg/g), magnesium (52 microg/g vs 72 microg/g), iron (5.9 microg/g vs 7.1 microg/g), copper (28.3 microg/g vs 40.2 microg/g) and manganese (140 ng/g vs 190 ng/g). Calcium, magnesium, iron, and manganese were loaded in the same factor using factor analysis; the mean of this factor was significantly lower in fibromyalgia group in multivariate analysis with adjustment for potential confounders. In conclusion, the concentrations of calcium, magnesium, iron, and manganese in the hair of female patients with fibromyalgia are lower than of controls, even after adjustment of potential confounders.
Adult ; Body Height ; Body Mass Index ; Calcium/analysis ; Female ; Fibromyalgia/*metabolism ; Hair/*chemistry ; Humans ; Iron/analysis ; Magnesium/analysis ; Manganese/analysis ; Metals/*analysis ; Middle Aged

BACKGROUND: The quality control for genetic tests would be of great importance as the test volume and clinical demands increase dramatically. Diagnostic genetics subcommittee of KSQACL performed two trials for cytogenetics and molecular genetics surveys in 2009. METHODS: A total of 67 laboratories participated in the cytogenetic surveys, 30 laboratories participated in the FISH surveys, and 94 laboratories participated in the molsecular genetics surveys in 2009. RESULTS: Almost of them showed acceptable results. However, some laboratories showed unacceptable results for the karyotype nomenclature and detection of complex cytogenetic abnormalities in hematologic neoplasms, and most of them except one showed acceptable results in FISH surveys. The molecular genetics surveys included various tests: M. tuberculosis detection, hepatitis B (HBV) and C virus (HCV) detection and quantification, human papilloma virus (HPV) genotyping, Influenza A (H1N1) detection, gene rearrangement tests for leukemias and lymphomas, apolipoprotein E (APOE) genotyping, methylenetetrahydrofolate reductase (MTHFR) genotyping, hereditary breast and ovarian cancer genes (BRCA1 and BRCA2), and genetic tests for achondroplasia (FGFR3), FMS-like tyrosine kinase 3 (FLT3), JAK2, BRAF, hereditary disorders such as spinal muscular atrophy, Huntington disease (HD), spinocerebellar ataxia (SCA), Prader-Willi/Angelman syndrome (PWS/AS), mitochondrial encephalopathy with lactic acidosis and strokelike episodes (MELAS), myoclonic epilepsy ragged red fiber (MERRF), wilson disease (ATP7B) and cancer-associated genes (KRAS). Molecular genetic surveys showed excellent results in most of the participants. CONCLUSIONS: External quality assessment program for genetic analysis in 2009 was proved to be helpful in continuous education and evaluation of quality improvement.
Achondroplasia ; Acidosis, Lactic ; Apolipoproteins ; Breast ; Chromosome Aberrations ; Cytogenetics ; Epilepsies, Myoclonic ; fms-Like Tyrosine Kinase 3 ; Gene Rearrangement ; Hematologic Neoplasms ; Hepatitis B ; Hepatolenticular Degeneration ; Humans ; Huntington Disease ; Influenza, Human ; Karyotype ; Korea ; Leukemia ; Lymphoma ; Methylenetetrahydrofolate Reductase (NADPH2) ; Mitochondrial Encephalomyopathies ; Molecular Biology ; Muscular Atrophy, Spinal ; Ovarian Neoplasms ; Papilloma ; Quality Control ; Quality Improvement ; Spinocerebellar Ataxias ; Tuberculosis ; Viruses

The importance of quality control for dramatically growing genetic tests continues to be emphasized with increasing clinical demands. Diagnostic genetics subcommitee of KSQACP performed two trials for cytogenetic study in 2007. Cytogenetic surveys were performed by 42 laboratories and answered correctly in most laboratories except some problems in karyotype nomenclature and the detection of complex cytogenetic abnormalities in hematologic neoplasias. The molecular genetics surveys included many kinds of tests: M. tuberculosis detection, hepatitis B (HBV) and C virus (HCV) detection and quantification, human papilloma virus (HPV) genotyping, gene rearrangement tests for leukemias and lymphomas, apolipoprotein E (APOE) genotyping, methylenetetrahydrofolate reductase (MTHFR) genotyping, hereditary breast and ovarian cancer genes (BRCA1 and BRCA2), and genetic tests for hereditary conditions such as Duchenne muscular dystrophy (DMD), Huntington disease, spinocerebellar ataxia, spinal muscular atrophy, and Prader-Willi/Angelman syndrome. Molecular genetic surveys showed excellent results in most of participants. External quality assessment program for genetic analysis in 2007 was proved to be helpful in continuous education and evaluation of quality improvement.
Apolipoproteins ; Breast ; Chromosome Aberrations ; Cytogenetics ; Gene Rearrangement ; Hepatitis B ; Humans ; Huntington Disease ; Karyotype ; Korea ; Leukemia ; Lymphoma ; Methylenetetrahydrofolate Reductase (NADPH2) ; Molecular Biology ; Muscular Atrophy, Spinal ; Muscular Dystrophy, Duchenne ; Ovarian Neoplasms ; Papilloma ; Quality Control ; Spinocerebellar Ataxias ; Tuberculosis ; Viruses